Hormone Predicts Death Risk in Kidney Patients
Reported September 14, 2011
(Ivanhoe Newswire) – High levels of a hormone, FGF-23, can predict which kidney
patients will develop heart problems, require dialysis, or die prematurely,
according to this study.
"This discovery allows us to predict at-risk patients before they require
dialysis," lead investigator Michel Chonchol, MD, an associate professor of
medicine specializing in nephrology, was quoted as saying. "That's critical
because approximately 23 percent of patients on dialysis die in the first year."
Chonchol and fellow CU School of Medicine researcher Jessica Kendrick, MD,
studied the blood plasma of patients with advanced kidney disease and found that
levels of fibroblast growth factor-23 increased as the patient's kidney function
decreased.
The hormone regulates phosphorous levels in the body. As the kidneys fail, they
are unable to excrete phosphorous which raises FGF-23 levels. The higher the
hormone levels, the greater chance the patient will die.
"At this point we don't know how the hormone changes the body," Chonchol said.
By the time a patient is down to just 30 or 40 percent kidney function, the
levels of FGF-23 can predict who will die, have a cardiac event or end up on
dialysis. Almost 50 percent of the deaths result from cardiovascular issues like
heart attack.
Until now, doctors relied on measuring phosphorous to assess phosphate balance
in patients with kidney disease.
"Prior to a patient going on dialysis the phosphorous levels shoot up," Chonchol
said.
But he found that long before phosphorous levels jump, FGF-23 levels have
already increased. Identifying this earlier will allow doctors to intervene with
drugs that can lower phosphorous which would then lower the hormone level.
"This has provided us a critical marker to look for," Chonchol said, "A marker
that could save lives."
Kidney disease currently afflicts 20 million Americans and is a growing problem
as the nation gets increasingly obese and diabetes continues to rise.
"The best ways to prevent kidney disease is through blood pressure control,
diet, exercise and maintaining a healthy body weight," Chonchol said.
SOURCE: Journal of the American Society of Nephrology, published online
September 9, 2011 |